Lower Extremity Arterial Mapping: Duplex Ultrasound as an Alternative to Arteriography Prior to Femoral, Popliteal, and Infrapopliteal Reconstructions

Abstract

This chapter summarizes our clinical experience with periprocedural duplex ultrasound performed to plan over 3000 lower extremity open and endovascular arterial revascularization procedures. The topics discussed include objectives of preoperative duplex ultrasound arterial mapping (DUAM) for revascularization decision-making, detailed DUAM protocols, comparison of DUAM with other imaging modalities such as contrast arteriography (XRA), computed tomographic arteriography (CTA), and magnetic resonance angiography (MRA). We also reviewed the learning curve for detailed duplex arterial testing as well as the limitations and pitfalls of this diagnostic technique including necessary components to be followed during the training phase before replacing other imaging modalities with DUAM.